ETHANS GLOBAL LLC NPI 1346709714

NPI Details

ETHANS GLOBAL LLC is a community/retail pharmacy pharmacy in Ypsilanti, MI. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. ETHANS GLOBAL LLC NPI is 1346709714. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

300 W MICHIGAN AVE STE 200
YPSILANTI, MI
ZIP 48197-443
Phone: (734) 667-1764
Fax: (888) 850-9288

The provider's authorized official is Jacqueline Mbwille Sakaya .
The authorized official title is Pharmacy Owner and has the following contact phone number (734) 667-1764.

The CLIA number assigned to this NPI record is 23D2199696 - pharmacy with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

• Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
• Covid-19 vaccine administration inside a patient's home; reported only once per individual home per date of service when only covid-19 vaccine administration is performed at the patient's home (HCPCS:M0201)
• Fee covid-19 vac 14 res (HCPCS:0134A)
• Administration of influenza virus vaccine (HCPCS:G0008)
• Influenza vaccine split virus, preservative free (HCPCS:90662)
• Fee covid-19 vac 13 res (HCPCS:0124A)
• Adm sarscv2 30mcg trs-sucr b (HCPCS:0054A)
• Adm sarscov2 30mcg/0.3ml bst (HCPCS:0004A)
• Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 100 mcg/0.5ml dosage; first dose (HCPCS:0011A)
• Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 100 mcg/0.5ml dosage; second dose (HCPCS:0012A)
• Influenza vaccine, quadrivalent, 0.5 ml dosage (HCPCS:90688)

The enumeration date for this NPI number is 3/15/2019 and was last updated on 10/2/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available: